I have a patient presented to me with reduced fetal movement for 3 days associated with irrregular uterine contraction at 36 weeks. When I examine her, she was pink, vital signs stable. On examnation of the abdomen, the abdomen was tense. There was no per-vaginal bleed and hematuria. When I did a scan on her, the placenta was fundal. THERE WAS NO RETROPLACENTA CLOT SEEN!. When I ordered a CTG for her, the CTG was pathological, showing sinusoidal pattern. Emergency Caesarean Section was planned. Intraoperatively, there was 400cc retroplacenta clot!!! and the baby had low Apgar Score of 3 at 1 min, 5 at 5 min and 7 at 10 min! The baby was intubated.
I am sure abruption placenta is the cause of fetal distress in this patient.
So, please do not rely on ultrasound to diagnose placenta abruptio especially the concealed type.
